Provider Demographics
NPI:1457540627
Name:COLLINS-MCNEIL, JANICE (FNP)
Entity Type:Individual
Prefix:PROF
First Name:JANICE
Middle Name:
Last Name:COLLINS-MCNEIL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:JANICE
Other - Middle Name:
Other - Last Name:COLLINS-BANKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:5200 GRENELEFE VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-3073
Mailing Address - Country:US
Mailing Address - Phone:704-907-1173
Mailing Address - Fax:
Practice Address - Street 1:3050 REGENT BLVD STE 200
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-5806
Practice Address - Country:US
Practice Address - Phone:321-775-3533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201545363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily